What is Plummer’s Disease? An Overview of the Causes and Symptoms

Plummer’s disease

Plummer’s disease, also known as toxic multinodular goitre, is a thyroid condition characterized by enlargement of the thyroid glands, firm thyroid nodules, and an overproduction of thyroid hormones (hyperthyroidism.)

With plummer’s disease, one or more nodules may be enlarged; however, they may not all overproduce hormones. The overproduction of thyroid hormones (thyroxine) affects the body in many ways and can lead to heart problems, osteoporosis, cancer, and more.

Luckily, the prognosis of plummer’s disease is good, and many treatments are available. Keep reading to learn more about the causes, symptoms, and treatment of plummer’s disease.

Causes

The etiology of plummer’s disease is currently unknown; however, genetic factors and nutritional deficiencies may play a role in the disease’s onset.

Genetics- Multiple gene mutations have been linked to the onset of plummer’s disease. Plummer’s disease research is limited, but many researchers believe there may be more genetic or hereditary causes for the disease.

Iodine deficiency- Iodine deficiency is the most common cause of plummer’s disease. Iodine plays a principal role in thyroxine production, and without the hormone damage may occur to the thyroid gland. 

Age and Sex- Plummer’s disease is more prevalent in women than men and tends to affect the elderly. Finding plummer’s disease in children is an incredibly rare occurrence.

History of thyroid problems- Individuals struggling with thyroid conditions such as hyperthyroidism and grave’s disease are at greater risk for developing plummer’s disease because the damage and dysfunction are already present.

Symptoms

Since plummer’s disease affects various parts of the body, many symptoms may occur when battling the disease. 

Some of the most common symptoms include:

  • Excessive tiredness or fatigue
  • Frequent or irregular bowel movements
  • Heat intolerance
  • Increase appetite
  • Loss of appetite or unintentional weight loss
  • Increased or abnormal sweating
  • Irregular menstrual periods
  • Muscle pain or cramps
  • Anxiety or nervousness
  • Restlessness
  • Changes in mood
  • Changes in memory
  • Heart palpitations or chest pain
  • Weakness

Often, individuals with plummer’s disease are not able to recognize the symptoms or experience no symptoms for years after development. 

Diagnosis

If an individual feels they may have plummer’s disease, a visit to the doctor can quickly provide a diagnosis. 

Plummer’s disease is diagnosed with a physical exam, blood tests, imaging scans (ultrasound), or a CT scan. Testing is non-invasive, and results are generally received the same day or within the week.

Treatment

Once a plummer’s disease diagnosis is received, various treatment options may be presented.

The treatment options available include surgery, radioiodine therapy, ethanol injections, medications, and medical marijuana.

Surgery

Surgery may be required for individuals when large goitres are causing breathing difficulty, cancer is present in the thyroid, or repeated treatment is needed. 

Surgery entails the resection of part or the whole thyroid gland and is reserved for individuals with more severe cases. In rare cases, thyroid hormone replacement is necessary after surgery.

Radioiodine Therapy

Radioiodine therapy is a nuclear medicine treatment and is highly effective in the treatment of plummer’s disease. The thyroid absorbs most of the iodine put into the body which means that radioactive iodine can target and destroy the thyroid goitre or cancer with minimal effects on the rest of the body.

Radioiodine is given to an individual in capsule form or liquid if needed.

Ethanol Injections

With the help of a sonogram, ethanol injections can be administered directly to the thyroid. 

Ethanol injections are generally split between two or three visits and typically result in no complications other than minor discomfort.

Medications

If an individual has few symptoms and small goitres, their doctor may start treating them with medication. The most common medication used is a beta-blocker called propranolol. This medication is highly lipid soluble, which allows it to concentrate in tissues to inhibit monodeiodinase activity ( the activation or deactivation of thyroid hormones.)

Medical Marijuana

Medical marijuana is often used to treat symptoms of plummer’s disease and the symptoms associated with other treatments. 

Cannabis can relieve pain, regulate mood, increase energy, reduce inflammation, and help insomnia and digestion. Since plummer’s disease is most often found in the elderly, symptoms of insomnia and digestive issues may already be prevalent, making cannabis highly beneficial. 

Additionally, marijuana’s anti-inflammatory benefits are great for plummer’s disease patients because individuals with hyperthyroidism often have grave’s disease, which creates inflammation throughout the entire body.  

 

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